ACE Personal Trainer Manual Chapter 16: Emergency Procedures

D

A heart attack is characterized by which of the following signs and symptoms? A. A sudden, severe headache and weakness on one side of the body B. Sustained stabbing pain in and around the chest C. Sudden loss of consciousness, with no breathing and no pulse D. A squeezing pressure in the chest that can be mistaken for heart burn

The trainer should give two breaths into the mouth of the victim while pinching the nose

Answer the following question about the primary assessment of an emergency incident. What should the personal trainer do if an assessment of the victim's breathing reveals that it is gasping or irregular?

The victim is conscious and speaking, or is unconscious and stable ABCs

Answer the following question about the secondary assessment of an emergency incident. What are the 2 possible indicators that it is time to move into secondary assessment of a victim?

Skin that is warm and has a pinkish tone indicates adequate blood flow and oxygenation, whereas grayish, pale skin may indicate poor circulation

Answer the following question about the secondary assessment of an emergency incident. What can a quick check of skin color and temperature reveal about the victim's general health?

To address any issues that are not immediately life-threatening

Answer the following question about the secondary assessment of an emergency incident. What is the purpose of the secondary assessment?

A=Airways B=Breathing C=Circulation s=Severe bleeding

Define the 4 components of the ABCs used as part of the primary assessment to determine if an emergency is life-threatening. A= B= C= s=

-Heart attacks begin with chest pain called angina pectoris, which is described as chest pressure or a squeezing feeling, which may be mistaken for heart burn. This pain can also travel to one or both arms (typically the left arm), the neck, the jaw, shoulder, or stomach. The back may also be affected. -Shortness of breath may accompany these symptoms, and may even be without any chest pain. -Nausea, a cold sweat and lightheadedness may also occur. For women, the most common symptom is also chest pain, but women are more likely than men to experience nausea, shortness of breath, and back or jaw pain.

Describe the initial signs and symptoms of each of the following common medical emergencies; Heart Attack

The onset of hypoglycemia may be rapid and can be displayed as headache, hunger, weakness, sweating, or fatigue.

Describe the initial signs and symptoms of each of the following common medical emergencies; Hypoglycemia

The signs and symptoms of shock include restlessness; anxiety; altered mental status; pale, cool, and clammy skin; fast and weak pulse; irregular breathing; nausea; and thirst.

Describe the initial signs and symptoms of each of the following common medical emergencies; Shock

If the right hemisphere of the brain is affected by a stroke, the signs and symptoms will appear on the right side of the face but the left side of the body due to the crossing over of cranial nerves. This can cause a facial droop on the right side, weakness or paralysis on the left side of the body, vision problems, memory loss, and a quick, inquisitive type of behavior.

Describe the initial signs and symptoms of each of the following common medical emergencies; Stroke affecting the right side of the brain

A tonic clonic seizure usually starts with an "aura" the person experiencs a smell or sound that indicates a seizure is about to occur. When the seizure starts, the victim experiences loss of consciousness and whole body jerking movements, where the muscles contract and relax, the jaw is clenched, and bowel or bladder control might be lost. This could last one or more minutes, and is followed by a state of exhaustion called the postictal state. The victim may still be unconscious in this state for 10 - 30 minutes.

Describe the initial signs and symptoms of each of the following common medical emergencies; Tonic clonic seizure

He most likely is having a hypoglycemic reaction. Check the airway, breathing, and circulation. Activate the EMS system. Protect the victim and prevent injury in case of a seizure. Do not give anything by mouth.

Identify the common medical emergency or injury and outline your response; 45 minutes into training a client, you begin to notice the client is starting to act a bit unsteady and weak. He complains that he is tired and has a severe headache. As he attempts to sit down, he falls backward and is lying on the floor unconscious.

1. The name of the victim 2. The date and time of the incident 3. What happened 4. What was done to care for the victim and by whom 5. Names, addresses, and phone numbers of witnesses

What 5 pieces of information must be included on the incident report following an emergency?

-Wear gloves -Use a protective barrier device when performing CPR -If there is potential for blood to splash, a gown and eye protection should be worn

What are the universal percautions that a rescuer can use to stay protected from bloodborne pathogens?

C

What is the MOST common heart rhythm during cardiac arrest? A. Atrial fibrillation B. Atrial bradycardia C. Ventricular fibrillation D. Ventricular tachycardia

C

What is the MOST important step a fitness facility can take to minimize risks of cardiovascular events? A. Having each member complete a release of liability waiver and informed consent B. Requiring all members to have physical examinations before beginning exercise programs C. Having each member complete a medical history form D. Requiring all members to start programs at a low to moderate intensity

B

What is the PRIMARY reason people give for not attempting CPR in a cardiac emergency? A. Fear of law suits due to cracked ribs B. Uncertainty about their ability to perform CPR correctly C. Fear of performing CPR when it is not needed D. Uncomfortable putting their mouth on a stranger

D

What should you do FIRST with a person who suddenly falls to the floor while exercising? A. Ask the person what led to the injury B. Check for any medical jewelry to determine the cause of the condition C. Assess the person's pulse and blood pressure D. Assess if he person is conscious and asking if he or she is okay

1. Amnesia 2. Confusion 3. Memory loss 4. Headache 5. Drowsiness 6. Loss of consciousness 7. Impaired speech 8. Tinnitus 9. Unequal pupil size 10. Nausea 11. Vomiting 12. Balance problems or dizziness 13. Blurry or double vision 14. Sensitivity to light or noise 15. Any change to the individual's behavior, thinking, or physical functioning

List 15 warning signs that personal trainers must be aware of when monitoring an individual following a possible concussion

1. What is your emergency? 2. Where is your emergency and what number are you calling from? 3. What is your name? 4. Is the victim conscious? 5. Is the victim breathing normally? 6. Are you able to assist with CPR? 7. Do you have access to an AED?

List 7 questions that a caller must be ready to answer when calling 9-1-1 to report an emergency.

R=Rest or Restricted activity; necessary to allow the body to heal I=Ice; should be applied for 20 minutes to relieve swelling and pain C=Compression; helps prevent swelling and should be applied distally and wrapped proximally E=Elevation; elevating the injury above the level of the heart can help reduce swelling

List the 4 components of the RICE acronym and explain the role of each in the treatment of soft-tissue injuries

1. Clear the area so the victim will not hit his head on nearby furniture or objects 2. Place a towel under the victims head to help protect it from injury 3. Never restrain the victim or place anything in the victim's mouth 4. Have someone phone EMS

List the 4 emergency procedures for a generalized tonic clonic seizure

1. Early access 2. Early CPR 3. Early defibrillation 4. Early advanced care

List the 4 steps in the AHA's Chain of Survival

A bystander only needs to remember to push hard and fast on the center of the victim's chest until trained help arrives.

Explain the "hands-only" CPR, defining for who it might be effective and why.

Tilt the head back and lift the chin to move the tongue away from the back of the throat. Check for breathing by looking at the chest and listening and feeling for breath.

Answer the following question about the primary assessment of an emergency incident. Explain how to perform the chin-lift maneuver for opening the victim's airway.

In this situation, implied consent can be assumed. The trainer should proceed by checking for the ABCs.

Answer the following question about the primary assessment of an emergency incident. If a victim is unable to give consent to receive help because he or she is unresponsive or disoriented, how should the personal trainer proceed?

Without a pulse, the victim will need immediate CPR, starting with chest compressions

Answer the following question about the primary assessment of an emergency incident. What is the next step if the initial assessment of the victim's circulation has found no pulse?

The PAR-Q can help identify high-risk individuals who need medical referral or require modifications to their exercise programs. It can also help identify the need for additional qualified staff members if there are a number of high risk clients.

How can the use of the Physical Activity Readiness Questionnaire (PAR-Q) help prevent an emergency situation?

C

How is a transient ischemic attack (TIA) different from a stroke? A. A TIA is caused by a different physiological mechanism B. A stroke is not treatable, but a TIA is C. Signs of a TIA last less than one hour D. A TIA feels less severe and is less frightening than a stroke

To care for a victim of heat stroke, call EMS if the person displays any abnormal signs, such as confusion, vomitting, inability to drink, red hot and dry skin due to an inability to sweat, shallow breathing, seizures, or unresponsiveness. Cool the victim immediately, do not wait for EMS. Get the person into a shady area, remove any tight clothes, and apply ice packs to areas of high blood flow such as the groin, axilla (armpit), and neck or submerge victim in a tub of ice water. If the person can swallow, it is safe o give him or her cool fluids to drink, but not if the person is vomiting, is confused or unresponsive, or has a seizure. Monitor the ABCs and core temperature. Once the person's behavior is back to normal, stop the cooling so that a state of hypothermia does not develop.

How should a personal trainer care for a victim of heat stroke?

First activate EMS. Attempt to place a barrier between you and any wounds or blood by wearing gloves or grabbing a towel or shirt. Next, apply direct pressure to the wounds and elevate the arms above the heart. If others are available, ask if they can obtain gloves and a barrier so they can apply pressure to the wounds or other pressure points at the brachial site. Do not apply a tourniquet, as pressure and elevation should stop bleeding until help arrives. Try to calm victim through reassurance. Help paramedics when they arrive. You will need to wash your entire body with soap and water since you've been showered with blood. Any objects that have been in contact with blood, must be contained and properly washed or disposed of.

Identify the common medical emergency or injury and outline your response; You notice your client is stretching his calf muscle by placing one leg behind the other and pushing on a wall. You then notice your client is actually pushing on a large window. As you walk over to warn him, the glass gives way and your client receives multiple cuts to his hands and wrists. He is bleeding profusely from his wrists and blood gets on your hands, face, and clothes.

It is appropriate to call EMS when there is a life threatening situation or anything that requires immediate medical attention, such as a person who is not breathing, has an open wound to the chest, or is bleeding profusely

When is it appropriate to call 9-1-1?

A

Which of the following CORRECTLY describes the Health Insurance Portability and Accountability Act (HIPAA) of 1996? A. It ensures individual privacy by requiring confidentiality of health documents B. It requires an individual to share health information with his or her physician C. It requires an individual to share health information with his or her insurance agency D. It ensures that individual heath records are accessible at all times via an electronic database

A

Which of the following are actions to take when you suspect a client is having a mild hypoglycemic incident? A. Help the client sit down and give him a sugary drink if he can swallow B. Call EMS rescuers, start the steps of CPR, and get an available AED C. Help the client sit down and give him insulin if he has it available D. Immediately call for EMS rescuers to respond and monitor the person

B

Which of the following is a critical indicator that someone is suffering from heat stroke and in need of emergency treatment? A. Increased body temperature B. Altered mental status C. Red hot, sweaty skin D. Fatigue, weakness, and headache

A C D E

Which scenarios make it appropriate to call 9-1-1 or activate the EMS system? a. A client has a seizure b. A client breaks his or her femur c. A client suddenly cannot move a part of his or her body d. A client is having trouble breathing e. A carbon monoxide alarm is activated f. A trainer wants to check on the status of an ongoing emergency

D

Which treatment of soft-tissue injuries is within the personal trainer scope of practice? A. Recommending that the client take NSAIDs B. Performing massage on the affected soft tissue C. Administering ultrasound to the affected soft tissue D. Educating the client on the proper administration of ice using the P.R.I.C.E. principle